Smokers to be axed from waiting lists

An English health authority is to become the first to penalise smokers by taking them off waiting lists for surgery.

Health chiefs have taken the radical step because they say operating on smokers is more expensive.

Smokers are being ordered to try to quit their habit before surgery or risk losing the chance of an operation as Norfolk's health chiefs introduce radical steps to save money.

Norfolk Primary Care Trust, which is £50 million ($140 million) in the red, said smokers were being targeted because they are at increased risk of complications and take more time to recover from surgery.

This means they have longer and more expensive stays in hospital.

The new regulations, approved by the Norfolk trust, cover non-urgent operations such as hip and knee replacements or hernia operations.

They stress smokers needing urgent surgery will not be affected by the policy.

The trust recognises the healthy lifestyle benefits of the move but also makes no secret of the fact that it is introducing the policy as a cash-saver because it says smokers cost more money.

But smokers claimed they were being unfairly picked on, while GPs opposed the approach saying it "inappropriately disadvantaged" smokers.

Norfolk trust's new director of public health Dr John Battersby said: "There is increasing evidence that smokers have three times the number of complications as non-smokers. What we are proposing is that, if someone who smokes is being referred for surgery, we would instead want them to be referred to a smoking cessation clinic and give them three months to stop smoking."

Complications smokers are vulnerable to after surgery include wounds taking longer to heal - leading to a greater risk of infection - and blood clots. And for those needing vascular surgery, on blood vessels, the risks are higher, often with a greater likelihood of an artery clogging up again .

Dr Battersby said: "What we are doing is asking people to have a stab at giving up for three months and at the end we would review the situation. Some people will have stopped and will go on and have a referral for surgery. Others will not have stopped."

If smokers have tried hard and need the surgery, they may get it. But if it is felt they have not made a strong effort to stop and are at high risk from the proposed surgery, they may not be referred for the operation.

- INDEPENDENT